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Pediatric voiding cystourethrography: An essential examination for urologists but a terrible experience for children
Author(s) -
Johnin Kazuyoshi,
Kobayashi Kenichi,
Tsuru Teruhiko,
Yoshida Tetsuya,
Kageyama Susumu,
Kawauchi Akihiro
Publication year - 2019
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13881
Subject(s) - cystourethrography , vesicoureteral reflux , medicine , urinary system , pediatric urology , urology , reflux , pediatrics , disease
Voiding cystourethrography is the most important fluoroscopic examination in pediatric urology for the investigation of lower urogenital tract diseases, such as vesicoureteral reflux or urethral stricture. However, this invasive procedure imposes a significant burden on children and their parents, and recently there has been a paradigm shift in the diagnosis and treatment of vesicoureteral reflux. In the 2011 revision, the American Academy of Pediatrics guidelines on urinary tract infection recommended abandoning routine voiding cystourethrography after the first febrile urinary tract infection. In 2014, the randomized intervention for children with vesicoureteral reflux study recommended discontinuation of routine continuous antibiotic prophylaxis for vesicoureteral reflux. The time is now ripe to radically reconsider indications for voiding cystourethrography and the procedure itself.